| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NORTHWEST | 601 UNION STREET, SUITE 1000 SEATTLE, WA 98101 | REGENCE BLUECROSS BLUESHIELD OF OREGON | $62K | $144 | $63K | 4.51% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | $0 | $6K | 5.48% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62949 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.31% |
| RYAN DONALD AUGHENBAUGH3 Filed as: RYAN D AUGHENBAUGH AND OTHER AGENTS | 16543 SOUTH WINDY CITY ROAD MULINO, OR 97042 | AFLAC | $399 | $0 | $399 | 4.54% |
| DONALD J. CLAY3 | 12405 NE 6TH COURT VANCOUVER, WA 98685 | AFLAC | $285 | $0 | $285 | 3.24% |
| VERENA NORTH3 | 17299 SOUTH NORTH END ROAD OREGON CITY, OR 97045 | AFLAC | $101 | $0 | $101 | 1.15% |
| JEAN ANN SCHINDELHEIM3 | 554 DEW POINT AVENUE CARLSBAD, CA 92011 | AFLAC | $95 | $0 | $95 | 1.08% |
| MARIE HELENA EVANS3 | 13004 NW MARINA WAY PORTLAND, OR 97231 | AFLAC | $79 | $0 | $79 | 0.90% |
| SHANE SCALF3 | 809 NE 10TH STREET BATTLE GROUND, WA 98604 | AFLAC | $72 | $0 | $72 | 0.82% |
| STEPHANIE L SANDERS3 | 27305 LIVE OAK ROAD, SUITE A437 SANTA CLARITA, CA 91384 | AFLAC | $59 | $0 | $59 | 0.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITEDHEALTHCARE INSURANCE COMPANY | $54 | $0 | $54 | 0.95% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 105 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 153 | $2.1M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 146 | $103K |
| Vision | VISION SERVICE PLAN | 143 | $21K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 146 | $109K |
| Short-term disability | AFLAC | 16 | $9K |
| Prescription drug(2 contracts, 2 carriers) | REGENCE BLUECROSS BLUESHIELD OF OREGON | 153 | $2.1M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 146 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.